﻿<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <title>创建</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
    <link rel="stylesheet" href="../Layui/css/layui.css" media="all">
</head>
<body>
    <form class="layui-form" action="">
        <div class="layui-form-item" style="margin-top:10px;">
            <label class="layui-form-label">学员信息</label>
            <div class="layui-input-inline">
                <input type="text" name="CustName" required lay-verify="required" placeholder="请输入宝宝姓名" autocomplete="off" class="layui-input">
            </div>
            <div class="layui-input-inline">
                <input type="text" name="CustTel" required lay-verify="required" placeholder="请输入联系电话" autocomplete="off" class="layui-input">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">出生日期</label>
            <div class="layui-input-inline">
                <input type="text" name="BirdDate" id="BirdDate" required lay-verify="required" placeholder="请选择出生日期" autocomplete="off" class="layui-input">
            </div>
            <div class="layui-input-inline">
                <input type="checkbox" name="BirDateState" lay-skin="switch"><div class="layui-form-mid layui-word-aux"> 出生日期已确认</div>
            </div>

        </div>

        <div class="layui-form-item">
            <label class="layui-form-label">宝宝小名</label>
            <div class="layui-input-inline">
                <input type="text" name="ChildName" required lay-verify="required" placeholder="请输入宝宝小名" autocomplete="off" class="layui-input">
            </div>
            <label class="layui-form-label">性别</label>
            <div class="layui-input-block">
                <input type="radio" name="sex" value="男" title="男">
                <input type="radio" name="sex" value="女" title="女" checked>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系人</label>
            <div class="layui-input-inline">
                <input type="text" name="LinkName" required lay-verify="required" placeholder="请输入联系人" autocomplete="off" class="layui-input">
            </div>
            <label class="layui-form-label">关系</label>
            <div class="layui-input-inline">
                <select name="LinkRelation" lay-verify="required">
                    <option value=""></option>
                    <option value="妈妈">妈妈</option>
                    <option value="爸爸">爸爸</option>
                    <option value="爷爷">爷爷</option>
                    <option value="奶奶">奶奶</option>
                    <option value="外公">外公</option>
                    <option value="外婆">外婆</option>
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">学生来源</label>
            <div class="layui-input-block">
                <select name="CustFrom" lay-verify="required">
                    <option value=""></option>
                    <option value="0">地推</option>
                    <option value="1">电话</option>
                    <option value="2">广州</option>
                    <option value="3">深圳</option>
                    <option value="4">杭州</option>
                </select>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">来源备注</label>
            <div class="layui-input-block">
                <input type="text" name="CusFromRemark" required lay-verify="required" placeholder="请输入来源备注" autocomplete="off" class="layui-input">
            </div>
           
        </div>
        <div class="layui-form-item layui-form-text">
            <label class="layui-form-label">备注</label>
            <div class="layui-input-block">
                <textarea name="CustRemark" placeholder="请输入内容" class="layui-textarea"></textarea>
            </div>
        </div>
        <div class="layui-form-item">
            <div class="layui-input-block">
                <button class="layui-btn" lay-submit lay-filter="formDemo">立即提交</button>
                <button type="reset" class="layui-btn layui-btn-primary">重置</button>
            </div>
        </div>
    </form>
    <script src="../Layui/layui.js"></script>

    <script>
        layui.config({
            base: '../Layui/' //静态资源所在路径
        }).extend({
            index: 'lib/index' //主入口模块
        }).use('index');
    </script>
    <script>
        //Demo
        layui.use('form', function () {
            var form = layui.form;

            //监听提交
            form.on('submit(formDemo)', function (data) {
                layer.msg(JSON.stringify(data.field));
                return false;
            });
        });
    </script>
    <script>
        layui.use('laydate', function () {
            var laydate = layui.laydate;

            //执行一个laydate实例
            laydate.render({
                elem: '#BirdDate' //指定元素
            });

          
        });
    </script>
</body>
</html>